糖尿病临床研究

　　[摘要] 目的 观察2型糖尿病(T2DM)胃轻瘫(T2DM+胃轻瘫组)患者与单纯T2DM(T2DM组)患者不同时期血糖水平和胃排空率变化，探讨T2DM胃轻瘫患者血糖水平变化规律，为临床应用降糖药物提供时间调整依据。方法：选取单纯糖尿病患者50例，糖尿病胃轻瘫患者50例，比较空腹及进食馒头餐150g后1 hPG、2 hPG、3 hPG、4 hPG水平变化。超声胃液体排空功能检查比较两组30 min、60 min、90 min、120 min、180 min胃排空率。结果 T2DM+胃轻瘫组FPG、4 hPG高于T2DM组[FPG(12.56±3.48)vs(9.84±2.13)mmol/L;4 hPG(15.26±4.87)vs (10.16±1.27)mmol/L] (P<0.01);T2DM+胃轻瘫组1 h~3 hPG水平低于T2DM组[1 hPG(13.16±2.87)vs (16.58±2.64)mmol/L;2 hPG(14.27±3.1) vs (19.86±4.34)mmol/L;3 hPG(14.89±4.13) vs (16.86±2.17)mmol/L] (P均<0.01)。T2DM胃轻瘫组各时间胃排空率低于单纯T2DM组[30 min(10.2±1.3)% vs (30.8±3.9)%;60 min(17.9±2.3)% vs (38.8±3.5);90 min(30.1±4.1)% vs (56.8±6.1)%;120 min(47.9±5.6)% vs (78.9±7.6)%;180 min(68.9±8.1)% vs (95.7±9.6)%] (P均<0.01)。血糖水平与胃排空率呈正相关(r为0.75，P<0.05)。结论 T2DM胃轻瘫患者胃排空率异常导致血糖水平的明显变化有时相特点，可为临床降糖药物给药时间调整提供理论依据，避免血糖波动过大。

　　[关键词] T2DM，2型;胃轻瘫;血糖

　　[Abstract] Objective To observe the characteristics of blood glucose levels and gastric emptying rate in different phases in T2DM with gastroparesis (T2DM+gastroparesis group) and in T2DM without gastroparesis (T2DM group), so as to provide evidence for the time adjustment in using hypoglycemic drugs. Results Fasting blood glucose(FPG) (12.56±3.48 mmol/L) and 4 hPG (15.26±4.87 mmol/L) in T2DM+gastroparesis group were significantly higher than that in T2DM group ( FPG 9.84±2.13 mmol/L, and 4 hPG 10.16±1.27 mmol/L, respectively) ( all P<0.01); 1hPG (13.16±2.87 mmol/L)， 2hPG (14.27±3.12 mmol/L) and 3hPG(14.89±4.13 mmol/L) in T2DM+gastroparesis group were significantly lower than in T2DM group(1hPG 16.58±2.64 mmol/L, 2hPG 19.86±4.34 mmol/L and 3hPG 16.86±2.17 mmol/L, respectively) (all P<0.01). Gastric emptying rate in patients with diabetic gastroparesis at different time points [30 min (10.2±1.3)%;60 min (17.9±2.3)%;90 min(30.1±4.1)%;120 min(47.9±5.6)%;180 min (68.9±8.1)%] were all significantly lower than that of pure diabetic patients [30 min(30.8±3.9)%;60 min(38.8±3.5)%;90 min(56.8±6.1)%;120 min(78.9±7.6)%;180 min(95.7±9.6)% ] ( all P<0.01). The blood glucose was positively correlated with the rate of gastric emptying (r=0.75，P<0.05). Conclusion The changes of blood glucose had phase characteristics due to the abnormal gastric emptying in diabetic patients with gastroparesis. These findings provided theoretical evidence for the time adjustment in administration with anti-diabetic drugs.

　　[Key words] Diabetes mellitus, type 2; Gastroparesis; Blood glucose